Valvular Atrial Fibrillation (AF)

In 2022, we would consider quote unquote valvular AF as someone with mitral stenosis, moderate or severe, or the presence of a prosthetic valve. If you are meeting one of those three criteria to cardiovert upfront, you can give the oral anticoagulant as soon as possible before the cardioversion when you're able. Sometimes we would give a shot of heparin before we cardiovert because there's some old data showing that within like 30 seconds after you restore sinus rhythm, you can already form some smoke in a left atrial appendage. So if you really feel that the patient is high risk for stroke, you can given a shot of IV